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Interazioni tra farmaci

Fluvoxamine + Methylene blue

Gravità: Controindicata

Fluvoxamine and Methylene blue: contraindicated interaction.

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Sintesi

Methylene blue is a potent reversible MAO-A inhibitor, and with serotonergic drugs such as fluvoxamine it can cause serious serotonin syndrome. Cases have occurred with intravenous doses used for methemoglobinemia or vasoplegia.

Cosa significa questa interazione in parole semplici

Fluvoxamine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Livello di evidenza: High

Perché avviene

MAO-A inhibition by methylene blue combined with serotonin reuptake inhibition by fluvoxamine causes excess serotonin.

Cosa fare

Avoid combined use; where methylene blue is urgently needed, stop fluvoxamine and monitor for serotonin toxicity for an extended period, noting that fluvoxamine's washout is relatively short compared with fluoxetine.

Cosa chiedere al farmacista

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Domande frequenti

Can I take Fluvoxamine with Methylene blue?

MediHelp rates the interaction as contraindicated. Fluvoxamine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Methylene blue is a potent reversible MAO-A inhibitor, and with serotonergic drugs such as fluvoxamine it can cause serious serotonin syndrome. Cases have occurred with intravenous doses used for methemoglobinemia or vasoplegia.

How serious is the interaction between Fluvoxamine and Methylene blue?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combined use; where methylene blue is urgently needed, stop fluvoxamine and monitor for serotonin toxicity for an extended period, noting that fluvoxamine's washout is relatively short compared with fluoxetine.

What other medicines interact with Fluvoxamine?

MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.

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